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Platelet-rich plasma versus exchange intramedullary nailing in treatment of long bone oligotrophic nonunions

  • Original Article • LOWER LIMB - FRACTURES
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

The aim of the study was to evaluate the effects of platelet-rich plasma on healing rates and healing time in the treatment of long bone nonunions treated by an intramedullary nail previously.

Materials and methods

Between August 2008 and January 2012, 14 consecutive patients who were treated for long bone nonunions with percutaneous platelet-rich plasma application (PRP) were included in the study. The control group included 15 consecutive patients who were treated with exchange intramedullary nailing (EIN). In the postoperative period, all patients were controlled in every 2 weeks clinically and in every 4 weeks radiologically. Patients were evaluated with visual analog scale (VAS) in preoperative and postoperative periods.

Results

The mean healing time was shorter in PRP group as 16.71 ± 2.4 weeks compared with that of 19.07 ± 3.67 weeks in EIN group (p = 0.053). At the end of the follow-up, the union is achieved in 92.8% of the cases in PRP group. This ratio was 80% in control group. The mean VAS values in preoperative and postoperative periods were not statistically significant in both groups (p > 0.05). When PRP and control groups were evaluated individually, the postoperative VAS was lower than that of preoperative VAS in both groups (p = 0.0001 and p = 0.0001, respectively).

Conclusion

Percutaneous PRP application significantly affected union rate, but no significant difference found when compared to EIN in the treatment of oligotrophic nonunions after intramedullary nailing of long bone fractures. PRP can be applied as a minimally invasive and safe method of saving resources in medical care instead of EIN.

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey

    Altuğ Duramaz, Mustafa Gökhan Bilgili & Berhan Bayram

  2. Department of Orthopedics and Traumatology, Atatürk Education and Research Hospital, İzmir Katip Çelebi University, Basın St., 35360, Karabağlar, Izmir, Turkey

    Hüseyin Tamer Ursavaş

  3. Department of Orthopedics and Traumatology, Turhal State Hospital, Maraşal Fevzi Çakmak St., 60300, Turhal, Tokat, Turkey

    Alkan Bayrak

  4. Private Orthopedics and Traumatology Clinic, Incirli St. Number 11, Kartaltepe, 34144, Bakırköy/Istanbul, Turkey

    Mustafa Cevdet Avkan

Authors
  1. Altuğ Duramaz
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  2. Hüseyin Tamer Ursavaş
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  3. Mustafa Gökhan Bilgili
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Correspondence to Altuğ Duramaz.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Additional information

The study “Platelet-Rich Plasma Versus Exchange Intramedullary Nailing in Treatment of Long Bone Oligotrophic Nonunions” was performed in Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey.

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Duramaz, A., Ursavaş, H.T., Bilgili, M.G. et al. Platelet-rich plasma versus exchange intramedullary nailing in treatment of long bone oligotrophic nonunions. Eur J Orthop Surg Traumatol 28, 131–137 (2018). https://doi.org/10.1007/s00590-017-2024-7

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  • DOI: https://doi.org/10.1007/s00590-017-2024-7

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